Miracle, Malcolm Baker
Miracle, Malcolm Baker is an sole proprietor health care provider with primary practice located at 7607 Dixie Hwy , Florence KY 41042-2644. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Miracle, Malcolm Baker can be contacted via phone (859) 655-6100.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6261 | Kentucky |
Profile Details
| NPI number | 1124184056 |
|---|---|
| LBN Legal business name | Miracle, Malcolm Baker |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2006 |
| Last updated | May 4th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124184056 | NPPES |
| Kentucky | Other | 62610 | DELTA DENTAL |
| Kentucky | Other | E973 | DELTA DENTAL |
| Kentucky | MEDICAID | 60062619 | DELTA DENTAL |
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